In this report, severely mentally ill adults describe their experiences of long-term illness. Forty-three research participants completed Life Chart Interviews covering their personal history since the onset of their psychiatric disorder. Participants appeared to be generally reliable informants on their treatment histories. They indicated that individual learning and personal choices influenced the course of the psychiatric disorder over time, including decisions about use of treatment and environmental support. These results support the value of life-context approach to research on severe mental illness.